AI Impact in Home Care- Top 15 Process to Automate with AI

Did you know that nearly 40% of agencies struggle with operational inefficiencies? This operational efficiency stems from multiple processes involved in offering client care, like referral intake, EVV compliance management, and creating seamless communication between agencies and caregivers. According to a report 4 in 10 home care providers have shut down their services in 2023 due to higher cost operations.

on the other hand, home healthcare market is projected to grow at a compound annual growth rate (CAGR) of 7.96% from 2024 to 2030. As more people seek care from the comfort of their homes, it is time for home care agencies to look for technological solutions like AI in-home care. Home care automation solutions can transform how we manage and deliver care and bridge the gap between growth and efficiency.

But what are the opportunities in home care processes, and how can automation become a part of them? Let’s explore the home care processes and how automation can accelerate the overall home care experience.

Home Care Process to Automate using AI and Automation

With the higher adoption of home healthcare services, home healthcare teams grapple with unnecessary inefficiencies. Hindered by outdated technology and disjointed systems that have persisted for decades, it’s imperative to reconsider how these teams handle the overwhelming administrative workload.

Excessive and laborious hours devoted to monotonous tasks lead to staff burnout, resulting in subpar patient outcomes, diminished revenue recognition, staff retention challenge and notable operational drawbacks. But here, cloud solutions for home care can be a saviour for home healthcare teams and help them automate administrative tasks and offer on-time patient care.

Let’s look at some home care processes that can be automated using AI and automation.

1. Electronic Visit Verification Process

   An electronic visit verification system requires tracking various information, including the type of service performed, the location of the service, the medical notes generated, the location and date of the service, who provided the service, who received it, and when the service began and ended. Caregivers often miss the opportunity to clock in/clock out and enter the service provided to patients, and with missing information, it becomes challenging for home care providers to create billing and initiate payments.

   Instead of the administrative team following up with caregivers and patients, the AI bot can connect with them via SMS/Call to record input and update the system. This helps homecare agencies improve compliance, get paid and improve the cash flow cycle.

2. Referral Intake

   Home care agencies receive referrals through different channels, including portals and online directories, healthcare providers, insurance providers, community organizations, agency websites, etc. From intake automation, patient information collection, and referral triage, home care agencies go through many tasks.

   Here, automation solutions for home care can be easily integrated with referral portals, perform data extraction from referral faxes using intelligent document processing, check the eligibility on the insurance portal, combine with the EMR system, prioritization, and perform automated matching and episode creation with minimal or no human intervention. This leads to improved care quality and faster response time to referrals.

3. Prior Authorization

   Prior authorization involves seeking approval from a payer before delivering specific services to a client. This encompasses the identification of services that necessitate authorization, the submission of authorization requests, and the subsequent tracking of the outcome of the approval.

   Here, AI in home care can seamlessly integrate with payer systems, accelerating the electronic submission of requests and expediting the review and approval process for authorized services. These prior authorization bots also provide real-time tracking and updates on submitted requests, minimizing uncertainty and enabling proactive follow-up with payers. Furthermore, they verify client eligibility for specific services in real-time, ensuring accurate service requests and mitigating denied claims.

4. AI Staffing

   Home care agencies encounter the complex challenge of aligning the most suitable caregivers with their clients daily. This intricate puzzle demands thoughtful evaluation of skills and requirements and smooth communication and coordination.
   The AI Staffing agent excels in skill-based matching, taking into account caregiver availability, preferred hours, and workload preferences. Simultaneously, it considers client needs and schedules to ensure a harmonious alignment between caregivers and clients. Also, AI bots can quickly identify and resolve scheduling conflicts in real-time and offer continuity of care.

5. Client Engagement

   Communication is the most important when offering quality care to home care providers. Leveraging automation in client engagement through chatbots or SMS empowers clients with self-service options, a user-friendly interface, and an approval mechanism.
   This enhances the client experience and delivers substantial advantages for clients and home care agencies. Using AI bots, home care agencies facilitate communication with ready FAQs, push notifications, self-service assistance, and automated reminders. This empowers clients to manage their care more actively.

6. OASIS Assessment Upload

   Uploading the OASIS assessment to iQIES involves gathering information about a patient’s health status, functional capabilities, and service requirements. The upload frequency may range from weekly for volatile clients to approximately every 60 days for stable clients with minimal changes in their needs.

   OASIS assessment upload bot with AI and automation streamlines the swift transfer of assessment data from your Electronic Health Record (EHR) or clinical documentation system to iQIES, eliminating manual data entry. This saves processing time and reduces errors typically associated with manual typing. Additionally, AI facilitates rapid data transfer and submission, expediting reimbursement processing and payment cycles that are compliant with regulatory standards.

7. Client Signature Matching

   Client signatures and authorizations are essential for care plan approval, service consent, and information release. AI bots swiftly handle extensive signature volumes, drastically reducing authorization turnaround times compared to manual verification.
   AI and automation solution for home care effectively decrease administrative overhead and mitigate potential errors linked to manual verification, enabling agency administration staff to concentrate on crucial tasks. Additionally, the bots are adept at detecting inconsistencies, thwarting unauthorized transactions, and safeguarding client information.

8. Eligibility Check

   The eligibility checks assess whether a client qualifies for diverse home care services and funding channels. This involves collecting client information, identifying funding sources, confirming eligibility for each source, and establishing service levels and coverage. Automating manual data entry and verification substantially decreases the administrative workload, allowing staff to focus on critical tasks like client care and service planning.

   Additionally, eligibility check bots eradicate human errors linked to manual data handling, enhancing the precision of eligibility determinations and mitigating compliance risks. Integrating automation and AI solutions also diminishes administrative costs tied to manual verification and paperwork, improving overall operational efficiency.

9. Claims Processing

   Claims submission involves electronically reporting provided services to a client’s insurance plan or government program for reimbursement. Home care agencies can automate this process using automation and AI solutions.
   In the automation of claims submission, a bot accesses the EMR system, retrieves processed claims, and uploads them to the insurance payer portal or clearinghouse for reimbursement. This way, automation alleviates administrative burdens, boosts cash flow, and elevates accuracy and compliance for home care agencies.

10. Denial Management

    Denial management involves recognizing, comprehending, and resolving claim denials from payers regarding services rendered to clients. A well-executed denial management process is essential for organizations to optimize revenue, guarantee correct service reimbursement, and deliver quality care without financial burden.

    Automating denial management process streamlines the monitoring of submitted claims, identification of denied claims, automatic retrieval of denial notifications and Explanation of Benefits (EOBs), filtering, updating Electronic Health Records (EHR), and directing claims to staff for correction. This reduces administrative burdens and allows home care agencies to focus on quality care.

11. Caregiver Engagement

    Caregiver experience matters the most regarding client retention for home care agencies. In daily working hours, a caregiver has a lot of tasks that need to be taken care of. Home care agencies can create automated assistance for caregivers. AI in home care Caregiver Engagement offers a comprehensive solution, including a Chatbot, assistance with Electronic Visit Verification (EVV) updates, self-service automation for payroll requests, scheduling tools, and personalized dashboards tailored for home care agencies.

12. Voice Note

    Voice notes prove invaluable to caregivers by relieving them of the burdensome task of manual note-taking. Through a voice bot, caregivers can effortlessly create and update notes in the EMR system by dictating information. Caregivers can edit their dictation if necessary by calling a designated phone number, providing a hands-free documentation experience. This method offers flexibility, allowing notes to be recorded in the caregiver’s preferred language, and ultimately contributes to more precise and improved documentation.

13. Virtual Caregiver

    The shortage of high-quality caregivers underscores the need for their efficient utilization. Virtual caregivers, equipped with voice, chat, and SMS text capabilities, offer clients regular check-ins, reducing reliance solely on in-person visits. Moreover, these virtual caregivers empower clients to proactively communicate changes in their condition, facilitating early interventions and better outcomes.

    Also, the bots efficiently collect and log client data, including symptoms, vital signs, and medication adherence, ensuring continuous monitoring and early issue identification. Additionally, virtual caregivers enable home care agencies to remotely monitor clients, potentially reducing the necessity for in-person visits and travel time, thereby saving valuable time and resources. The insights from virtual caregiving contribute to enhanced care planning and resource allocation, ultimately improving overall outcomes.

14. Caregiver Point System Dashboard

    Implementing an automated point system through an AI bot serves as an effective strategy to recognize and incentivize caregivers. This system rewards positive behavior, ultimately contributing to the retention and longevity of caregivers within the organization. This AI bot seamlessly integrates with various data sources, offering live dashboards enabling providers to monitor real-time performance.
    The automated point system dashboard enhances provider outcomes by improving hiring rates, enhancing reporting capabilities, and facilitating precise tracking of caregiver performance. Additionally, it empowers providers with insights into top-performing caregivers and offers many other benefits for optimizing caregiver management and overall healthcare service delivery.

15. Caregiver Onboarding

    Caregiver onboarding is a critical process for home care, yet it often presents numerous challenges. The hiring of caregivers involves handling large volumes of applications, manually inputting data, conducting background checks, and updating multiple systems throughout the process. The traditional manual approach is often propane to delays and inefficient workflow, which leads to slower onboarding time and frustrates new hires.

    AI in home care solutions can automate this process. AI bots can constantly monitor for new applicants, automatically detecting and pulling relevant information from their applications. Once a new applicant is detected, the bot immediately creates a corresponding profile in the HR system. It seamlessly transfers the applicant’s details across multiple systems, such as human resources management software (HRMS), ensuring that all information is updated and consistent throughout the organization. This on-time update and streamlined process allowed quicker progression through the onboarding stages.

The Future is Now- Embracing Home Care Automation

The future of home care is indeed here with AI and automation solutions. Embracing these technology and automation solutions for home care improves operations and creates a more efficient, responsive and human-centered than ever before. Addressing challenges like caregiver shortage, staff burnout and others requires a multifaceted solution approach. AutomationEdge’s AI and Automation cloud for home care is designed along with CareFlo to automate the repetitive home care process.

These CareFlo are pre-built solutions aiming to eliminate solution-building time and improve the process efficiency for home care agencies. Home care providers can seamlessly integrate CareFlo with their existing record-keeping systems, including EMR software, HR platforms, payer systems, and more. This integration drives substantial digital transformation for your agency, enabling effortless scalability and growth. So are you ready to boost your agency growth with AI and automation solution?

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